In This Issue

Sharing Signs of Progress at the State House
Leader’s Column: Business and Nursing -Proudly Working Together
NJNI’s Annual Meeting: Leading the Way Toward a Lifetime of Quality Care
Mastering the Classroom: New MSNs Talk About Teaching
Did You Know…?

Sharing Signs of Progress at the State House

New Jersey legislators had praise and questions for the health, business and academic leaders who gathered at the State House in Trenton on Nov. 19 to provide an update on progress made so far by the New Jersey Nursing Initiative (NJNI)—a multi-year, multi-million-dollar project of the Robert Wood Johnson Foundation (RWJF) and the New Jersey Chamber of Commerce Foundation.

Three-and-a-half years ago, representatives of RWJF and the Chamber Foundation announced the initiative at a hearing held by the same committee, the Senate Health, Human Services and Senior Citizens Committee. NJNI focuses on lowering the state’s nurse faculty vacancy rate, currently a staggering 10.5 percent, in order to help avert a projected shortage of more than 23,000 nurses in New Jersey in less than two decades.

“In 2009, when the New Jersey Nursing Initiative first launched, it was an unprecedented experiment in addressing the nurse faculty shortage in one state,” said John R. Lumpkin, MD, MPH, senior vice president and director of the Health Care Group at RWJF. “Today, three-and-a-half years later, I am pleased to be able to report: We are making real progress.”

In that time, Lumpkin and other witnesses said, NJNI’s Faculty Preparation Program has supported 61 New Jersey Nursing Scholars who are pursuing (or have completed) master’s or doctoral degrees that qualify them for nurse faculty positions. NJNI developed the Nursing Academic Resource Center of New Jersey, an online tool for graduate-level nursing students, and supported the Nursing Centralized Application System, which streamlines the nursing school application process for prospective students and monitors the availability of slots in nursing programs. NJNI also launched WeTeachNursingNJ.com, a website providing nurse faculty career information.

In addition, NJNI is taking a lead role in the New Jersey Action Coalition. It helps the Future of Nursing: Campaign for Action implement recommendations from the Institute of Medicine’s landmark nursing report as part of a nationwide effort to transform nursing and health care by fully utilizing nurses and enhancing their skills and education.

Increasing Demands on Nurses

“The nursing shortage is real,” Sen. Joseph Vitale, the chair of the health committee, said to those assembled in the packed hearing room. NJNI’s efforts “are very important.”

Susan Bakewell-Sachs, PhD, RN, PNP-BC, program director of the New Jersey Nursing Initiative and interim provost of The College of New Jersey, also testified, pointing out NJNI’s role in supporting the Nursing Faculty Loan Redemption Program Act, which was signed into law in 2010. It provides student loan redemption in exchange for full-time employment in the state as a nurse faculty member. “We have made important progress toward addressing the nursing and nursing faculty shortage and we thank the Legislature, and in particular this committee, for your support in helping us avert a serious health care crisis,” Bakewell-Sachs said.

Sen. Barbara Buono pointed out that as the Affordable Care Act is implemented, the need for primary care physicians will increase. She asked if NJNI’s efforts would lead to more advanced practice nurses who could offset some of the demand for more primary care. “Nurse practitioners contribute exquisitely to closing that gap,” said Mary Ann Christopher, MSN, RN, FAAN, president and CEO of the Visiting Nurse Service of New York and chair of NJNI’s National Advisory Committee. Christopher served as the moderator for the hearing. From the outset, NJNI knew that “we needed not only faculty, we needed faculty who understand increasing demands on nurses,” she responded.

‘It Is a Privilege to Teach’

Several senators raised questions about nurse faculty salaries, and they were eager to hear the perspective of Colleen Manzetti, DNP, RN, CNE, CNLCP, an assistant professor at Monmouth University. Manzetti shared her experience as a beneficiary of the state’s Nursing Faculty Loan Redemption Program, which provides a maximum benefit of $50,000 over five years. “The passion for teaching that nurse faculty members bring to their jobs is really what drives us, not the bottom line,” Manzetti said, citing the salary disparity between nurses in academia and nurses in the health care industry. “There is a great sense of accomplishment that comes with knowing that we improve the lives of patients, even when we’re not at their bedside in the hospital, because we give so many nurses the tools of caring they need. It is a privilege to teach, but financially, it is a sacrifice.”

The committee also heard from two New Jersey Nursing Scholars: Maria Torchia LoGrippo, MSN, RN, a doctoral student at Seton Hall University, and Marlin Gross, MSN, RN, who completed his master’s degree this year and is now an assistant professor at Cumberland County College.

LoGrippo spoke movingly of how her scholarship allowed her to meet academic and family demands—including caring for her two young children and her mother, who recently lost a two-year battle with breast cancer—without the financial pressure to hold a nursing job at the same time. “I now know for sure that I would not have been able to combine work and school without support from the New Jersey Nursing Initiative,” LoGrippo said. “I am well on the way to becoming a tenured nursing professor and the kind of academic nurse leader our nation needs to fix our health care system. I expect to spend the next several decades preparing the next generation of nurses and nurse faculty, who in turn will work to meet the health care needs of people in this state.”

“We need more highly educated nurses to play leading roles in discussions and debates about health care reform,” Gross said. “We need them to provide more complex care to an aging, and more complex, population of patients and to provide critically needed research into ways to improve health care. And we need them to fill faculty vacancies so we can curb a looming nursing shortage and help ensure that all people in our state, and in our country, have access to a highly skilled nurse when and where they need one.”

What’s Next for New Jersey

“We congratulate everyone involved in this initiative,” said Sen. Jim Whelan. “It’s a remarkable hearing, because you haven’t asked us for anything yet. What else do you look for going forward?”

“We’re here really for the reason of thanking you for your support,” responded Christopher. Early on, “some people may have doubted us. We would like for you to be mindful of nursing items in the future. We would like for you to be guardians of our efforts and champions for our work.”

The nursing population is aging, with only 8 percent of New Jersey nurses younger than 30. The average age of the state’s nurses is 51, and the average age of nurse faculty is 55. “Half of the faculty are thinking about retirement,” Lumpkin said. “We’re trying to get ahead of the curve.”

A recent study projects that by 2030, there will be a shortage of 23,358 nurses in New Jersey, indicating that NJNI’s work and similar efforts are crucial to ensuring that enough nurses can be trained to meet future health care needs in the Garden State. NJNI has awarded $21.5 million to a group of institutions of higher education to support the New Jersey Nursing Scholars with full tuition and fees, a $50,000 annual stipend and a laptop computer. Last year, RWJF reauthorized NJNI through 2016, funding scholarships for 10 additional New Jersey Nursing Scholars to pursue PhDs.

“This year, the Robert Wood Johnson Foundation celebrates its 40th anniversary,” Lumpkin said. “As we look back at the nearly $1.5 billion we’ve invested in New Jersey, nothing makes us prouder than our support of the New Jersey Nursing Initiative. We are transforming the nursing workforce to better serve New Jersey’s future health needs, and in doing so, we are creating a model worthy of broad replication across the nation.”

“We need to support this initiative—to enhance and elevate it,” Sen. Buono said. “This is a good start.”

Reproduced with permission of the Robert Wood Johnson Foundation, Princeton, N.J.
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Leader’s Column: Business and Nursing -Proudly Working Together

Jeffrey Scheininger, chair of the New Jersey Chamber of Commerce Board of Directors and president of Flexline/U.S. Brass & Copper Corp.

Scheininger was among the leaders who spoke on behalf of the New Jersey Nursing Initiative at the state Senate health committee hearing on Nov. 19. The following is an excerpt from his testimony.

I am exceptionally proud of the Chamber’s role in hosting the New Jersey Nursing Initiative since its inception. The state’s business community has long understood that a shortage of nurses and nurse faculty has serious implications for the welfare of our employees as well as the costs of running our enterprises. That is why the Chamber remains committed to the New Jersey Nursing Initiative and the forward-thinking steps it is taking to avert a health care crisis in our state.

I can speak to the business community’s concerns not only as the Chamber’s chairman, but also as the president of Flexline, a small manufacturer of specialty hose products, located in Linden. Several years ago, I had the privilege of testifying before this committee when the initiative was launched, and I spoke then of the business community’s deep concern about health care costs and the desire to make sure that quality care is available to support the health, well-being and productivity of our employees. That concern hasn’t changed, nor the reality that our employees won’t get quality care without highly educated nurses.

My health insurance expenditures are the same today as they were in 2009—around 30 percent of pre-tax profits. That would be great news—except we have 25 percent fewer employees now than we did then. So, in fact, we have experienced a significant increase in our health insurance costs. Believe me when I say I want to be sure that money is well spent, and that my employees are well served. We could grow our business significantly if not for this cost pressure.

Additionally, the Affordable Care Act has important implications for the nursing workforce. Millions of newly insured patients will require more health care professionals to care for them, and much of that care will come from qualified nurses. The breadth of medical decisions made by nurses instead of physicians will increase, and that requires not just having enough nurses, but having great nurses. And New Jersey needs to ensure that there are enough great nursing faculty in place to make that happen.

Tens of thousands of business owners, like me, want to know that the health care system is up to the job. That our employees and their families will have quality care when they or a family member is sick, and that the care that is available will make them well and let them get back to their jobs. We know that just as we form the bedrock of our state’s economy, nurses form the bedrock of the health care system.

The New Jersey Chamber of Commerce, its member companies and its coalition partners are proud to support the New Jersey Nursing Initiative, we are proud of the progress that’s been made, and we look forward to maintaining a strong alliance in the future.
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NJNI’s Annual Meeting: Leading the Way Toward a Lifetime of Quality Care

Think of the images that nursing programs use to promote themselves and the profession, urged Mathy Mezey, EdD, RN, FAAN, as she delivered the opening keynote address at the fourth annual meeting of the New Jersey Nursing Initiative (NJNI). “Looking at websites, you’d think you were going to be a pediatric nurse.”

Her words resonated with the scholars, mentors and faculty who assembled from Nov. 28 to 30 at the Robert Wood Johnson Foundation in Princeton, N.J. Reinforcing the meeting’s theme, “Leadership for a Lifetime: Shaping Gerontology Education and Policy in the Garden State,” she continued:

“From the minute we think about ourselves in nursing education, we see ourselves caring for the young. That’s not what nursing is today.”

Instead, older adults make up health care’s core business, said Mezey, professor emerita, senior research scientist and associate director of the Hartford Institute for Geriatric Nursing at the New York University College of Nursing. Yet, nursing programs generally don’t devote enough time to geriatrics, she said, creating an urgent educational need: “The emphasis should be where the majority of nurses will be working. You’re producing unsafe practitioners if they’re not prepared to care for older adults.”

‘You Have to Have the Science’

Mezey highlighted a number of broad efforts to elevate geriatrics—including Web-based clinical teaching modules, new models for advanced practice registered nurse (APRN) education and regulation,  geriatric summer institutes, and the Nurses Improving Care to Healthsystems Elders (NICHE) national initiative—but she also reminded the audience that faculty can effect change on their own.

“If you’re born today, you have an even chance of reaching your 100th birthday,” she said. And although many health care providers are gifted at caring for older adults, “it’s not just enough to have the art. You have to have the science.”

NJNI Program Director Susan Bakewell-Sachs , PhD, RN, PNP-BC, agreed wholeheartedly. A fundamental reason that NJNI exists, she said after Mezey’s address, is “the importance of science and transmitting that to our students. It’s about education informing practice and practice informing education.”

New Ideas for Older Adults

Attendees heard a second keynote address the following day, by Jennie Chin Hansen, MSN, RN, FAAN, the CEO of the American Geriatrics Society and recent past president of AARP. Additionally, Mezey and Hansen each moderated panel discussions that provided a range of perspectives on geriatrics. The meeting also included a Collaborative Learning Community session that focused on practical advice for new faculty who want to secure a tenure-track position at a research-intensive university.

“A lot of you come from acute-care settings, and one of the things I want you to think about is care that comes outside of institutions, because that applies to many older adults,” Hansen said during her keynote. She emphasized that a provision of the Affordable Care Act, the Independence at Home program, could have a significant, positive impact on geriatric care: “It’s really a much more dynamic way to deliver care to older adults, because you can respond to issues right away instead of waiting to schedule services elsewhere.”

“Acute care is an artificial environment, and it can be disorienting,” Hansen added. “We put people at such a disadvantage.”

‘A Tremendous Opportunity for Change’

As the meeting wound down following a panel discussion exploring topics such as end-of-life care and New Jersey’s Practitioner Orders for Life-Sustaining Treatment (POLST) law, doctoral scholar Aleesa Mobley, MS, RN, APNC, reflected on the cumulative effect of all the ideas that had been shared. “I see this as a beautiful transformation in how we think about caring for the elderly,” she said. “There’s a way to be healthy until you eventually die.”

“We need your talent and brains to think about these issues,” Hansen said. “There’s a tremendous opportunity for change, and it’s helpful for you to look closely at best practices whenever you can.”

“The context we have, and the work before us, is daunting,” said Bakewell-Sachs, “but it’s enriched by what we’ve learned here during this meeting. We’ve got to find our voices, take our voices forward, and transform leadership.”
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Mastering the Classroom: New MSNs Talk About Teaching

This year, 20 New Jersey Nursing Scholars completed their master of science in nursing (MSN) programs. We recently caught up with four alumni who went right back to class—as faculty:

• Nancy Flood, MSN, RN, an instructor at Monmouth University who teaches Health Research and Community Health
• Marlin Gross, MSN, APN, NP-C, an assistant professor at Cumberland County College who teaches Concepts in Nursing Practice I and II (theory, lab and clinical) and Leadership and Management in Nursing Practice
• Renee Kurz, MSN, FNP-BC, an instructor at the University of Medicine and Dentistry of New Jersey who teaches Capstone clinical in the accelerated BSN program; Primary Care of Adults and Gerontology clinical in the MSN program; and Adult Health I (didactic and clinical) in the BSN program
• Shelby Pitts, MSN, RN, an instructor at the University of Medicine and Dentistry of New Jersey who teaches Pediatric and Obstetric clinicals in the accelerated BSN program.

What is the biggest surprise about your new classroom role?

Flood: The amount of prep work necessary to teach each class.

Gross: I’ve been surprised by the receptiveness of the senior faculty to a novice educator. The mentoring and collaboration I’m experiencing are some of the highlights of my time as a new faculty member.

Kurz: I find it surprising how the use of technology permits ongoing communication with students, but also ends up being 24 hours a day.

Pitts: I have taught clinical in the past for an LPN program, so I haven’t had many surprises with the accelerated BSN program.

What is the biggest challenge you’ve faced so far in your teaching job?

Flood: Creating innovative strategies to keep my students engaged.

Gross: I’m finding that my biggest challenge is motivating students and engaging them in active learning. Simply knowing the content doesn’t make you a good teacher.

Kurz: My biggest challenge so far is securing clinical placements for graduate students. There are many students competing for few sites. This has caused some students to be delayed in starting clinical and to struggle to stay “caught up” the rest of the semester with both the paperwork and the clinical hour requirements.

Pitts: The students in my last pediatric group were not clinically strong and needed a lot of remediation on their assessment skills. I worked with the course coordinator and the lab coordinator to support those students who were weak in certain areas so that they would be able to meet the course objectives and gain professional confidence in their ability to provide exceptional nursing care.

What is your ultimate goal as a teacher, and what is your plan to achieve that goal?

Flood: I want to integrate nursing science and caring practices to provide my students with opportunities that connect classroom pedagogies with real clinical situations. To achieve that goal, I plan to continue teaching, work in a clinical setting, and pursue post-graduate education to practice in an advanced clinical capacity.

Gross: My ultimate goal as a teacher is to ensure that every student has the best educational experience possible, and I plan to accomplish that by keeping abreast of the latest information in health care and nursing education, as well as bringing my passion for and dedication to nursing education each time I enter the classroom. Also, I plan to pursue my doctorate and contribute to nursing research in areas of clinical practice and education.

Kurz: I want to become a full professor, and I’ve already taken several doctoral courses. I’ll resume my doctoral studies next fall in order to achieve this goal.

Pitts: My goal is to obtain my doctorate of nursing practice and continue to teach as clinical faculty. I was able to take a few doctorate-level courses during my master’s program, and I plan to continue next fall and complete my studies within two years.
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Did You Know…?

In 2011, the New Jersey Nursing Initiative (NJNI) awarded four grants for Innovations in Clinical Education (ICE), based upon a demonstrated partnership between an accredited school of nursing and a practice organization utilizing one of the following three approaches: a Dedicated Education Unit (DEU), preceptor strategies, or clinical simulation to connect classroom and clinical learning.